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Nothing is working - please help

I am currently trying to exclusively breast feed my 12 week old son. We had a ropey start with me being a bit unwell with blood loss after delivery, delayed milk arrival and him struggling to latch on. Once we got going he then failed to thrive with his weight going from the 75th to the 0.4th centile. We were referred to an infant feeding clinic and I am having to top him up with expressed milk and formula to make up the shortfall.

Here's what I am currently doing:

Eating and drinking (3-5L/day) fine
Feeding him 3hourly then giving 120ml top up
Using compressions when he feeds
Letting him go longer overnight (~5hours)
Expressing as often as I can - generally max of 6/day
Using a hospital grade breast pump to double pump since 2 days ago (previously hand or small electric pump)
Taking fenugreek and domperidone at max dose
Eating porridge for breakfast

I tried a "nursing vacation" a couple of weeks ago but that seemed to make no difference either.

Despite this my expressed volumes are going down. I've never needed breast pads and my son does not seem to ever finish a feed from me i.e. he never comes off the breast awake and satisfied. He will fall asleep there but once wakes when moved and is still hungry. Left to just breast feeding, feeds would just run into each other and eventually he would starve.

What else can I do? I really want this to work but my body is just not doing it. We don't have lactation consultants around here so that is not an option unfortunately. My husband works till late so it just me and my son till late evening so I lack an extra pair of hands.

Re: Nothing is working - please help

I'm sorry you and your little guy have had such a rough start! It sounds exhausting.

My first thought when I look at what you're doing is to recommend nursing far more frequently than you do. Possibly even as frequently as every hour, or two at the most. Your baby will do a far better job of removing milk from your breasts than the pump will, and it is the removal and the suckling action that cue your body to produce more.

Re: Nothing is working - please help

Right. Your feedings in the beginning DO almost run into each other. And it does NOT result in a starving child. It results in a dyad that makes the right amount of milk. You should be nursing 8-12 times in a 24hour period. THAT IS NORMAL. The amount of nursing/feeding required to make the right amount of milk. So even if your child isn't hungry that often (which happens when you supplement with formula. NOT because it's more satisfying than your milk. But because it take longer to digest.) YOU should still be pumping and stimulating your breasts that often. Because to get your child to your breast exclusively, that is the amount of milking that will be taking place.
Also can we get more precise stats? I mean when you say your child went from the 75th percentile to the .4 percentage what does that mean? How much did your child weigh? How much weight was lost?

Re: Nothing is working - please help

with PP.

Also you say left to fEed as much as he wants the baby would feed almost continuously? I would let him. That is his way of signalling to your body how much milk to make. Monitor his wets to see whether he needs further supplement-he should be having at least 6 per day.

I never needed breast pads either and am very resistant to leaking, no matter how engorged I get. I leaked a few times when my DD was less than 3 months old. But I did have sufficient milk to bf exclusively, so that in itself doesn't mean anything.

Aim to bf as often as he'll take it! Good luck mama, you can do this!

Mom to Taiga born 6/2010Pocket cloth diapers. Baby led solids. Full-time working mom. I my DH, DD, kitty Dr. Benway, and my working border collie Odin!
BF for 1 year and she and I still love it !!!!

Re: Nothing is working - please help

The centiles are from the UK growth charts. At birth he was 3.968kg so in the top 25% of the normal range. He dropped by 14% by day 3 but thereafter has been gaining weight and not losing but not gaining quickly enough. Some weeks he's only gained 10-20g which is why he's had to be supplemented with formula. At 9 weeks he was 4.03kg placing him in the bottom 0.4% of the normal range for his age. With the supplements he's now ~4.8kg so on the 2nd centile at 12 weeks. Does that clarify things?

Re: Nothing is working - please help

Well...your original post said he dropped from the 75th percentile to the .04 which is a huge difference from 25th percentile. And not gaining as quickly as they'd like IS way different and not nearly as large a concern in terms of not getting enough food as a child that actually LOSES weight. So yeah this gives a much clearer picture of what's really happening. Thank! This is not something that I think you could not over come by simply increasing your feedings. And working to lose your supplements. It's all supply and demand. More demand creates more supply.

Re: Nothing is working - please help

That is definitely really slow growth, but I am confused as to why you are going so long between feedings and supplement with formula rather than increasing the frequency of nursing sessions. Milk is supply and demand so the more often you nurse the more milk your body makes.

proud but exhausted working mammy to two high needs babies

my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and

the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.

If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

Family beds are awesome

Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

Re: Nothing is working - please help

Thanks, I think I need to know I'm not attempting the impossible. I get a lot of well meaning people saying things like, "You've given it a good go." or "At least he got your first milk." etc with the underlying implication of "just switch to formula". I don't want to do that. I want to breastfeed.

Re: Nothing is working - please help

Originally Posted by @llli*blap

Thanks, I think I need to know I'm not attempting the impossible. I get a lot of well meaning people saying things like, "You've given it a good go." or "At least he got your first milk." etc with the underlying implication of "just switch to formula". I don't want to do that. I want to breastfeed.
Okay, so I feed, feed, feed and anything else I get done is a bonus.

Anything else?

You've given it a good go, and we can help you give it a better go and continue as long as you and your sweet baby both want to.

And the bolded is pretty much it. Take care of the baby, anything else is a bonus. In time, your baby will be more efficient and more self-contained and you will get more done. Have faith! You're obviously dedicated. You can do this.

Re: Nothing is working - please help

That's right, just bf on cue and your milk will increase. It works You work There's nothing wrong with you. I bf my daughter at least every 45 minutes even up to 9mos, just followed her cues. Yes, it was a commitment but I never had trouble with supply, plugged ducts, mastitis; and she never had any ear infections, major illnesses, etc. I also lost baby weight which made me feel better. It was really cool for me to spend time with my daughter, burn calories bfing and surf the internet with my feet up, all at once.

Truthfully feedings every 3h is a schedule for formula-fed babies, because artifical milk is harder to digest than the ideally suited breast milk you make. I had to work through my cultural training that I had so much 'time off' between feedings. But anthropologically:http://kathydettwyler.org/detfreq.html

Try babywearing and bfing at the same time, so you can be a bit more mobile and bf conveniently. It helps Also if your hemisphere has warm weather now, enjoy it together, go to a park, take a walk in the sunshine, clear your mind. Ideally you can do that with a baby wrap and discreetly bf at the same time. Going out helps.

Katharine in BelgiumBe the change you want to see in the world--Mahatma Gandhi
DD2 Feb 2015 - natural birth VBAC with DD (2010) & DS (2011 VBAC)
Ouch! Is it thrush or Raynaud's phenomenon?